Mammalian cell extracts have been shown to carry out damage-specific DNA repair synthesis induced by a variety of lesions, including those created by UV and cisplatin. Here, we show that a single psoralen interstrand cross-link induces DNA synthesis in both the damaged plasmid and a second homologous unmodified plasmid coincubated in the extract. The presence of the second plasmid strongly stimulates repair synthesis in the cross-linked plasmid. Heterologous DNAs also stimulate repair synthesis to variable extents. Psoralen monoadducts and double-strand breaks do not induce repair synthesis in the unmodified plasmid, indicating that such incorporation is specific to interstrand cross-links. This induced repair synthesis is consistent with previous evidence indicating a recombinational mode of repair for interstrand cross-links. DNA synthesis is compromised in extracts from mutants (deficient in ERCC1, XPF, XRCC2, and XRCC3) which are all sensitive to DNA cross-linking agents but is normal in extracts from mutants (XP-A, XP-C, and XP-G) which are much less sensitive. Extracts from Fanconi anemia cells exhibit an intermediate to wild-type level of activity dependent upon the complementation group. The DNA synthesis deficit in ERCC1-and XPF-deficient extracts is restored by addition of purified ERCC1-XPF heterodimer. This system provides a biochemical assay for investigating mechanisms of interstrand cross-link repair and should also facilitate the identification and functional characterization of cellular proteins involved in repair of these lesions.DNA interstrand cross-linking agents are among the oldest and yet still most effective anticancer drugs available in the clinic, and the chemotherapeutic use of the early forms of these chemicals, such as mustard gas and nitrogen mustard, extends back to before the Second World War. The alkylation chemistry of these drugs was also elucidated shortly after that war, and their cellular pharmacology was extensively studied during the 1970s and 1980s (27). In contemporary chemotherapy, interstrand cross-linking agents such as cyclophosamide, melphalan, and cisplatin are among the most potent antitumor agents. Despite this lengthy history of clinical use and pharmacologic investigation, the mechanisms of repair of the lesions produced in DNA by interstrand cross-linking agents have not been extensively studied. This situation of relative neglect of biochemical pathways of cross-link repair contrasts with the striking advances that have been accomplished in the past decade in other DNA damage processing pathways, such as nucleotide excision repair (NER), base excision repair, and mismatch repair (18).Current evidence (44) indicates that the error-free repair of both interstrand cross-links and double-strand breaks involves a recombinational mechanism in which an undamaged donor chromosome provides a homologous copy for the repair of the damaged template. Both of these lesions are highly deleterious, and it has been shown in certain yeast genetic backgrounds in which particul...